Hello dear reader,
I write for a living. One of my favourite parts of this job is when I'm get to pen a packed piece that any therapist on any corner of this planet will find relevant, pertinent, and deeply relatable.
Today’s piece is something like that! :)
We invited Tanuja Babre, clinical director at Ally, to speak to our ongoing Applied Product Thinking for Therapists cohort.
Tanuja is a Mumbai, India, based counseling psychologist, clinical director at Ally, UN consultant, and faculty at the psychology graduate program at TISS School of Human Ecology.
She's spent fifteen years doing the thing most mental health practitioners are only beginning to consider: sitting in rooms with engineers, policy makers, and product teams, and holding the clinical line.
I spoke to her about the frustration that started it all, the skills nobody trains you for, and why she believes practitioners like you are not just welcome in tech, you're essential.
You've had a clinical career most therapists would consider whole and complete– iCALL, Arpan, UNICEF. At what point did you first think: the tools don't exist, and I might have to be part of building them?
My very first counseling session was on a school bench during lunch break with children screaming and running through the halls. And I remember thinking—this is not ideal. But more than that, I realized very quickly that what I was trained to do, sitting across a client in a quiet room, working through a long therapeutic process, is rarely consistently possible in a country like India.
My clients didn't always have that kind of time. They didn't always have the insight or the desire to invest in a slow process. They came when things fell apart. They came in crisis. And that was the first recognition: the shape of mental health care I had been trained for simply wasn't matching the shape of the need I was seeing.
At iCALL, choosing telephone as a medium was an access decision. If I'm offering free counseling only in English, it isn't really accessible to most people. So the question became: how do you make professional psychosocial support available in different shapes and forms that are actually acceptable to people?
At iCALL, your role shifted from counsellor to leading a 65-person team, designing workflows, building CRMs, managing digital systems. What did you have to teach yourself on the go?
Honestly? Clinical knowledge was maybe 25% of the actual work. The rest was leadership, operations, burnout management, grant writing, understanding how call-center technology works, and figuring out what a sticky agent is and whether it makes sense in a counseling context. None of that is in any traditional counseling curriculum.
The moment that crystallised it for me was when we had people with brilliant MBAs running mental health organizations. They would come in and say: your counsellor should be on the phone for seven and a half hours out of an eight-hour shift. That’s the efficiency target. And I had to explain why that was impossible! Why five hours on a crisis helpline is genuinely a stretch, why you can’t measure a counselor’s output the way you measure a sales call. But if I didn’t know their language, I couldn’t make that argument in a way they could hear.
So it became less about formal credentials and more about: I need to learn enough to stay in the room and keep the conversation honest. When Facebook and Twitter were grappling with self-harm disclosures in the early days, before any of this was even systematized, we were in consultations with their teams, trying to figure out together what an appropriate response even looked like. So it became less about formal credentials and more about I need to learn enough to stay in the room and keep the conversation honest.
You’ve worked with Meta, Google, UNFPA on protocols that became policy. When you walked into those rooms, how did you learn to translate clinical knowledge into something those spaces could actually use?
What made entry possible is that there was always a mutual need. I remember one particular evening—six partner organizations from across the world on a call with Meta, iCALL being one of them—and the question on the table was: what do we do about the Blue Whale challenge? This is happening right now. People are disclosing self-harm. We have no playbook. What should we do? They were genuinely lost. That’s a very different dynamic from walking in and pitching your agenda.
What gap have they [product teams] already identified? What are they struggling with? Because if I respond to their need first, I’m in a much better position to then shape what the solution looks like.
One conversation I remember clearly was about how our tools were flagging survivors who were sharing their own stories of self-harm as risky content. But for those people, talking about their experience was a moment of healing. So how do you give someone space to tell their story without making it unsafe for others? That nuance—that a disclosure and a healing narrative are not the same thing—is something only a clinician could bring to that table.
What came out of it was a feature where someone could anonymously send a message to a friend who’d posted something worrying: “I noticed, I care about you, here are some numbers.” It sounds small but it changed how the platform thought about peer support entirely. It introduced the idea of spreading responsibility rather than shifting it, or breaking mental health knowledge into modular pieces that people can choose from.
In 2021 you left iCALL after nearly seven years and went independent. What made it the right time and what were you most afraid of?
I had spent a decade building breadth. I had not built depth. My colleagues who stayed in clinical practice had specializations, a name in a particular kind of work. I had range, but I didn’t always have that deep vertical expertise to point to.
I also knew I was spending most of my time on things I wasn’t trained for: grant proposals, administrative operations, managing teams. I wasn’t doing enough mental health work. And that started to feel like a significant mismatch.
If this is sounding more and more useful, perhaps you want to consider being a part of the next Applied Product Thinking for Therapists Cohort where we you get front row seats when leaders like Tanuja speak? It's a 10 seats classroom and everyone tells me they're having fun and feeling confident and I'm living my dream doing this work so God yes I'm having fun!! but that's besides the point—join the waitlist?
The fear was relevance. I had been inside one ecosystem long enough that it had its own language. When you step outside, you don’t know if what you built inside those walls means anything to people who weren’t in them. And being younger than most people in those rooms added to it; I started leading iCALL at 26. I remember dressing up, wearing a sari, trying to carry myself a certain way in meetings, and still being the youngest person who often got talked past. My worry wasn’t competence. It was whether the space I had carved out inside iCALL would translate anywhere else.
You now hold multiple roles simultaneously: UN consultant, clinical director, faculty, your own firm. How do you stay clinically grounded across all of it?
I think what grounds me is moving between the levels. Two days ago I was speaking with someone doing mental health work near the India-Pakistan border in Rajasthan. I asked how she convinces people in that community to take difficult steps toward care. She said: “We tell them if you have a headache, you have to take the paracetamol yourself. I can’t take it on your behalf.” Nobody taught her that from a textbook. But that is what real mental health communication looks like in that context. I go back to a training room or a product meeting carrying that.
Then I sit in rooms with commissioners and IAS officers and look at what mental health means at scale, where does it fit in a campaign about child marriage, what’s the language that ministers respond to?
My therapy clients also teach me things. One told me recently she’d found a Facebook group of people who’d been through exactly what she was going through, and that group was doing more for her between sessions than almost anything else. I used to think of those as peripheral. Now I think they’re part of the ecosystem of care.
When you’re the clinical expert in a tech product team and the business logic pulls in a direction you think is harmful, what does that conflict look like, and how do you hold your seat at the table?
It happens constantly! Sometimes it’s profit logic, sometimes it’s just what’s easier to build. Someone suggests, “why not record real therapy sessions and use them to train the model, it will learn so much faster”. And my job is not to just say “No.” My job is to understand why they need that, and then find the next best option.
With Ally, we needed transcripts to train the system, and real session data was off the table, legally and ethically. So I suggested we build dummy transcripts with practitioners, and then use AI to replicate those into the thousands the system needed to find patterns. It’s not as good as real data. But it’s the next best thing, and it doesn’t compromise anyone.
The other thing I’ve learned is that people respond to law more than ethics. Citing privacy legislation in India, citing what is and isn’t legally permissible, that lands better than an ethical argument in a product meeting. As practitioners, we need to know the legal terrain, use it as a tool.
And of course sometimes you lose. Sometimes you make the argument persuasively, and the organization does it anyway. That doesn’t mean you sign off on it. You can disagree, say so, and not be complicit. But the times I’ve successfully navigated it have always been when I understood the reasoning behind the ask and came back with a real alternative.
In closing, if a therapist from this cohort said, “I want to contribute to a mental health product but I don’t know if I’m technical enough, or if anyone will take me seriously”, what would you want them to understand?
I want them to understand this clearly: if it is a mental health product, you and your client are the most important people in the room. Not the engineers. Not the investors. There is no product if the two of you are not at the center of it.
Anyone can build an app. Anyone can build a profitable app. But without you, they cannot build the app that offers this kind of nuanced care. You can read a person. You can translate distress. You can understand what a conversation in crisis actually sounds like and what it needs. None of the other people in that room can do that.
You need to genuinely believe that what you bring is irreplaceable, and then show up like it is.
The belief part is the actual work. If you walk into a product meeting secretly wondering whether you belong there, it shows in how much you push back, in whether you offer the alternative solution or just flag the problem, in whether you stay when it gets uncomfortable.
Practitioners who hold their ground in those rooms do it because they’ve internalized something: that clinical knowledge is not a nice-to-have that makes the product feel responsible. It is the thing that makes the product work. Until you believe that about yourself, the room will reflect your doubt back at you.
So you don’t need to learn to code. You need to own the space. Reclaim it. Because only if practitioners like you are building for mental health will ethical care sit at the top of the priority list.
Tanuja is the clinical director at Ally and founder of her own mental health consulting firm. She consults for UN agencies, advises on mental health policy, and teaches at TISS.
Ally is an AI-native nonprofit building open-source digital public goods to scale human care in mental health. Their mission is to support and strengthen the clinical workforce and the far larger non-clinical layer that forms the backbone of mental health care delivery.
Take care and see you soon,
Harshali
Founder, TinT
Follow along on @be_tint
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